Health-Related Quality of Life in Locally Advanced Cervical Cancer Patients After Definitive Chemoradiation Therapy Including Image Guided Adaptive Brachytherapy: An Analysis From the EMBRACE Study. Int J Radiat Oncol Biol Phys 2016 Apr 01;94(5):1088-98
Date
02/16/2016Pubmed ID
26876955DOI
10.1016/j.ijrobp.2015.12.363Scopus ID
2-s2.0-84960981708 (requires institutional sign-in at Scopus site) 76 CitationsAbstract
PURPOSE: This study analyzed functioning and symptom scores for longitudinal quality of life (QoL) from patients with locally advanced cervical cancer who underwent definitive chemoradiation therapy with image guided adaptive brachytherapy in the EMBRACE study.
METHODS AND MATERIALS: In total, 744 patients at a median follow-up of 21 months were included. QoL was prospectively assessed using European Organization for Research and Treatment of Cancer Quality of Life core module 30 (EORTC QLQ-C30) and EORTC cervical cancer module 24 (CX24) questionnaires at baseline, then every 3 months during the first year, every 6 months in the second and third years, and finally yearly thereafter in patients with no evidence of disease. Outcomes were evaluated over time and compared to those from an age-matched female reference population.
RESULTS: General QoL and emotional and social functioning were impaired at baseline but improved during the first 6 months after treatment, to reach a level comparable to that of the reference population, whereas cognitive functioning remained impaired. Both social and role functioning showed the lowest scores at baseline but which increased after treatment to reach a plateau at 6 months and then declined slightly at 3 and 4 years. The overall symptom experience was elevated at baseline and decreased to a level within the range of that of the reference population. Similarly, tumor-related symptoms (eg, pain, appetite loss, and constipation), which were present before treatment, decreased substantially at the first follow-up after treatment. Several treatment-related symptoms developed either immediately after and persisted over time (diarrhea, menopausal symptoms, peripheral neuropathy, and sexual functioning problems) or developed gradually after treatment (lymphedema and dyspnea).
CONCLUSIONS: This longitudinal prospective QoL analysis showed that patients' general QoL and functioning were impaired before treatment compared to those of reference data. Several tumor-related symptoms resolved after treatment, and functioning and general QoL returned to that of the level of the reference population, indicating a transient impact of diagnosis and treatment. However, several treatment-related symptoms and problems did develop and persist, either immediately or gradually after treatment.
Author List
Kirchheiner K, Pötter R, Tanderup K, Lindegaard JC, Haie-Meder C, Petrič P, Mahantshetty U, Jürgenliemk-Schulz IM, Rai B, Cooper R, Dörr W, Nout RA, EMBRACE Collaborative GroupAuthor
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Brachytherapy
Chemoradiotherapy
Female
Follow-Up Studies
Health Status
Humans
Middle Aged
Prospective Studies
Quality of Life
Radiotherapy Dosage
Radiotherapy, Image-Guided
Recovery of Function
Sexual Behavior
Surveys and Questionnaires
Time Factors
Uterine Cervical Neoplasms
Young Adult